Better Health Care Outcomes in Unprecedented Times: A Review of Conceptual Frameworks to Aid Understanding and Decision-Making

Abstract

Abstract

This article discusses conceptual frameworks of intelligence, moral development (ethical decision-making), and practical wisdom that can give useful guidance for understanding the moral issues involved in healthcare decision-making. The first framework we examine is the notion of "learnable intelligence"; that is, how we acquire "mindware," ways of thinking that are analogous to software that programs a computer. Sometimes, however, important mindware is missing or malfunctioning, preventing wise decision-making and requiring the mindware to be repaired or installed. The second framework concerns how people develop their moral rules; in particular, how the moral rules are based on reducing the harms we experience. The framework considered here includes violations of those moral rules in exceptional circumstance, and the decision guide for how we justify those violations, a framework that appears to comport with studies of moral development in children. The third framework examines a recently developed conceptualization of practical wisdom and presents examples of how it can be employed. This includes the problem of widespread misinformation about science in general and healthcare in particular, such as misconceptions of vaccine safety and efficacy. We outline current efforts made to understand this global phenomenon and to deal with the problems misinformation causes. Finally, we discuss suggestions for further research and practice.